HCY、叶酸和维生素B12联合检测慢性肾脏病的临床调查

Clinical investigate of joint detection of the HCY,Folic Acid and B12 in chronic kidney disease of different stages

目的探索HCY、叶酸和维生素B12水平在慢性肾病发生和发展中的变化趋势及临床进展的预测价值。方法收集2016年1月-2018年10月来本院就诊的未进行透析治疗的慢性肾病CKD临床各期患者静脉血3 ml,利用双试剂循环酶法检测HCY,采用化学发光微粒子免疫法检测叶酸和维生素B12水平。利用方差分析进行各期三项检测指标多重两两比较的差异显著性的统计学分析。结果随着慢性肾病的进展叶酸和B12水平降低:叶酸从Ⅰ期的(7.428±2.673)nmol/L降至Ⅴ期的(4.818±2.257)nmol/L;B12则从Ⅰ期的(355.567±78.195)pmol/L降至Ⅴ期的(312.761±82.355)pmol/L,各期与对照组有显著差异;HCY水平则随着肾小球滤过率降低逐期升高:从Ⅰ期的(11.997±2.981)μmol/L升至Ⅴ期的(33.666±9.812)μmol/L。结论联合检测HCY、叶酸和维生素B12的水平,对慢性肾脏疾病的早期诊断和各期发展有一定提示和预测作用。

Objective To explore the change trend of HCY,folic acid and vitamin B12 levels during the occurrence and development of chronic kidney disease(CKD)and the predictive value for clinical progress.Methods Three milliliter venous blood was collected from CKD patients of different stage hospitalized in our hospital during January 2016 and October 2018 and without receiving dialysis treatment.HCY,folic acid and vitamin B12 levels were detected by double reagent circulating enzyme method and chemiluminescent microparticle immunoassay,respectively.Analysis of variance by SPSS software was used to carry out statistical analysis on the significant difference of the three detection indexes in each period.Results With the development of CKD,levels of folic acid and vitamin B12 decreased,Folic acid decreased from(7.428±2.673)nmol/L in PhaseⅠto(4.818±2.257)nmol/L in PhaseⅤ,B12 decreased from(355.567±78.195)pmol/L in phaseⅠto(312.761±82.355)pmol/L in phaseⅤ.The concentrations were significantly different from those in the control group.HCY level increased from(11.997±2.981)μmol/L in phaseⅠto(33.666±9.812)μmol/L in phaseⅤas glomerular filtration rate decreased.Conclusions The combined detection of HCY,folic acid and vitamin B12 could help early diagnosis of CKD and predict its development of different stages.